Screening protocols, designated COVID-19 care units and in-house testing are all part of the contingency plans drafted by Philadelphia-based Temple University Hospital to meet the challenges brought on by the coronavirus pandemic.
Clinicians from the hospital shared their contingency plans in the Annals of the American Thoracic Society. The hospital is located in a medically underserved area, and 80 percent to 90 percent of intensive care unit beds are typically filled during normal operations, which makes preparing for an expected surge of coronavirus patients more difficult.
Pennsylvania has seen a rapid rise in coronavirus cases in the last few weeks, and the state had reported 36,082 cases and 1,673 deaths as of 1:30 p.m. CDT, April 22.
Soon after the pandemic began, the hospital started training staff on safety measures. The medical center's infection control committee drafted personal protective equipment protocols. The hospital also asked all staff to report symptoms online and started monitoring their temperature before and after shifts.
The clinicians created a screening protocol to classify patients based on likelihood of their transmitting the virus. Hospitalized patients are monitored for COVID-19-related changes and screened.
The hospital also developed its own in-house testing, which yields results in five to 10 hours.
The clinician team also developed coronavirus-specific admission protocols and determined the need for three units dedicated to COVID-19 care: an isolation unit separate from the hospital, a unit for patients with low probability of novel coronavirus infection, and an outpatient COVID-19 screening unit.
The team designated backup units and brought in ventilators from smaller satellite campuses. Staff not performing essential inpatient services were asked to stay at home and remain on reserve for staffing shortages.
The contingency plans also include discharge protocols, such as requiring that COVID-19-positive patients access an online portal to report their symptoms daily. If they are showing symptoms, more testing is conducted.
"Logistical deficiencies can stress the healthcare system, but with adequate preparation, we hope to reduce COVID-19 mortality by ensuring that the standard of care is preserved despite the increase in healthcare utilization," said study first author Junad M. Chowdhury, MD, pulmonary disease and critical care medicine fellow at Temple University Hospital.